Wisdom teeth, as the last teeth to grow in the human mouth, are often both loved and hated by many people. When many people visit the dentist, they are often advised to have their wisdom teeth extracted, which leaves many puzzled: Why should good teeth be pulled out? Is it really necessary to have wisdom teeth extracted? Next, from a professional dentist’s perspective, let’s have a detailed discussion about the reasons why dentists recommend extracting wisdom teeth.
Growth Characteristics and Root Causes of Wisdom Teeth
Wisdom teeth usually start to emerge around the age of 16 to 25. During this period, a person’s mind gradually matures, so wisdom teeth are also called “wisdom teeth”. However, from the perspective of oral medicine, the growth of wisdom teeth is full of “variables”. During the process of human evolution, the mandible has gradually become smaller, while the size and shape of wisdom teeth have not changed significantly. This has led to increasingly limited space for the growth of wisdom teeth in the oral cavity.
Under normal circumstances, teeth should be neatly aligned on the dental arch to perform functions such as chewing and pronunciation. However, due to insufficient space, most people’s wisdom teeth cannot emerge normally, and various growth problems will occur. These problems not only affect the wisdom teeth themselves, but also the surrounding teeth, gums and oral health. This is also the main reason why dentists often recommend extracting wisdom teeth.
A series of problems caused by impacted wisdom teeth
Pericoronitis of wisdom teeth recurs frequently
Impacted wisdom teeth are the most common condition, referring to the situation where wisdom teeth fail to emerge normally and are partially or completely covered by the gums. A narrow blind pocket will form between wisdom teeth and gums, where food debris, bacteria, etc. can easily accumulate. It is difficult to clean this area when brushing teeth. Over time, bacteria multiply in large numbers, which can lead to pericoronitis of wisdom teeth.
When pericoronitis of wisdom teeth occurs, patients will feel the gums around the wisdom teeth become red, swollen and painful. In severe cases, they may experience limited mouth opening, and even have difficulty eating and speaking. Inflammation may also spread to the cheeks and neck, causing facial swelling and even systemic symptoms such as fever and swollen lymph nodes. If pericoronitis recurs frequently, it will not only cause great pain to the patient, but also may lead to local tissue fibrosis, increasing the difficulty of subsequent treatment. For such repeatedly inflamed impacted wisdom teeth, dentists usually recommend timely extraction after the inflammation subsides to completely solve the problem.
Damage and caries of adjacent teeth
The growth directions of impacted wisdom teeth are diverse. Some grow laterally, while others grow obtusely towards adjacent teeth. This abnormal growth direction will exert continuous pressure on the adjacent teeth, leading to root resorption and loosening of the adjacent teeth. The enamel of adjacent teeth can also be damaged due to the compression of wisdom teeth, making it easier for bacteria to invade and causing caries in adjacent teeth.
Once the adjacent teeth are decayed, the treatment will be more complicated than that of ordinary dental caries. If the caries are severe, root canal treatment, crown restoration, or even the extraction of adjacent teeth may be necessary. In contrast, timely extraction of problematic wisdom teeth can not only prevent further damage to adjacent teeth but also reduce the cost and pain of subsequent complex treatments. Therefore, when dentists find that wisdom teeth are causing damage to adjacent teeth, they usually recommend extracting them as soon as possible to protect the health of the adjacent teeth.
Crowded teeth and malocclusion
For people with already crowded teeth, the eruption of wisdom teeth might be the “last straw that breaks the camel’s back”. The growth of wisdom teeth will occupy a limited space in the oral cavity, causing the originally neatly arranged teeth to be compressed, resulting in problems such as displacement and tilting, and aggravating the degree of tooth crowding.
Crowded teeth not only affect appearance but also the normal occlusal function of teeth. Malocclusion can lead to a decrease in chewing efficiency, increase the burden on the stomach and intestines, and in the long term, it may also cause temporomandibular joint diseases, presenting symptoms such as joint pain, clicking, and limited mouth opening. To ensure the neatness of the teeth and the normalcy of the bite, dentists usually also recommend the extraction of wisdom teeth that may cause a crowded teeth.
Problems with wisdom teeth themselves
Dental caries problem
Even if wisdom teeth can emerge normally, due to their backward position, they are difficult to clean thoroughly when brushing teeth, and food residues are prone to remain, providing a favorable environment for bacteria to survive. Therefore, the probability of wisdom teeth developing tooth decay is very high.
Once wisdom teeth become decayed, if the cavity is relatively shallow, it can be treated by filling the tooth. However, if the caries is severe and affects the dental pulp, root canal treatment is required. However, the root canal system of wisdom teeth is usually rather complex, difficult to treat, and after treatment, due to the limited chewing function, the significance of preservation is not significant. Therefore, for wisdom teeth that are severely decayed and difficult to treat, dentists usually recommend direct extraction to avoid repeated pain and infection.
No opposing teeth or occlusal trauma
Under normal circumstances, each tooth has a corresponding opposing tooth, and the upper and lower teeth cooperate with each other to complete the chewing action. But sometimes, wisdom teeth may have no opposing teeth, or the opposing teeth may be missing prematurely. In this case, wisdom teeth that do not bite the opponent will overgrow, and when biting, they are prone to bite the gums or mucous membranes of the opposing jaw, causing traumatic ulcers. At the same time, overgrown wisdom teeth can also disrupt the normal occlusal relationship and affect the chewing function of the oral cavity.
For wisdom teeth without opposing teeth or those that have caused occlusal trauma, in order to restore normal occlusal function and avoid further oral damage, dentists will also recommend their extraction.
Special Circumstances and Preventive Removal
Orthodontic treatment needs
When undergoing orthodontic treatment, to provide sufficient space for other teeth to move and achieve the desired orthodontic effect, it is often necessary to extract some teeth, and wisdom teeth are one of the common choices. Especially for conditions such as crowded or protruding teeth, extracting wisdom teeth can provide more space for orthodontic treatment, making the teeth align more neatly and improving facial aesthetics.
In addition, during orthodontic treatment, the presence of wisdom teeth may affect the movement of teeth and the orthodontic outcome. For instance, the force exerted by the eruption of wisdom teeth may cause the already aligned teeth to shift, affecting the stability of orthodontic treatment. Therefore, before orthodontic treatment, dentists will comprehensively assess the patient’s dental condition. If wisdom teeth are not conducive to orthodontic treatment, they usually recommend extracting the wisdom teeth first and then orthodontic treatment.
Preventive removal
Some wisdom teeth, although they do not show obvious symptoms at present, are found to be growing in poor positions through oral X-ray examinations, posing potential risks, such as being close to important nerves and blood vessels, or possibly leading to problems like jawbone cysts. In such cases, even if wisdom teeth do not cause pain or other discomfort, dentists may still recommend preventive extraction.
Preventive removal can avoid more serious problems that may occur in the future. For instance, if wisdom teeth are close to the inferior alveolar nerve, as they grow, they may compress the nerve, leading to serious consequences such as numbness of the lower lip. By removing it in advance, the risk can be minimized. Although preventive extraction may make patients feel that it is making a fuss over nothing, in the long run, it is a wise choice to protect oral health.
Not all wisdom teeth need to be extracted
Although there are many situations where wisdom teeth need to be extracted, not all wisdom teeth need to be simply removed. If wisdom teeth can emerge normally, are in the correct position and orientation, have a good occlusal relationship with the opposing teeth, and there are no problems such as caries or inflammation, they can be retained. This type of wisdom teeth can perform the chewing function normally and has no negative impact on oral health.
In addition, for some older patients with poor physical conditions who cannot tolerate tooth extraction surgery, even if there are certain problems with their wisdom teeth, dentists will carefully consider the patient’s overall condition and decide whether to extract the tooth. If the risk of tooth extraction is relatively high, conservative treatments such as local irrigation and medication may be adopted to relieve symptoms and control inflammation.
Conclusion
The dentist’s recommendation for wisdom tooth extraction is based on a comprehensive consideration of the patient’s oral health. Although wisdom teeth are part of the teeth, the problems they cause should not be underestimated. By understanding the reasons why dentists extract wisdom teeth, we can better understand and cooperate with the treatment, and protect our oral health well. If you still have any questions about wisdom tooth extraction, be sure to communicate with your dentist in a timely manner and listen to professional advice.
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